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Biography & Autobiography. Medical. Nonfiction. HTML:A riveting exploration of the most difficult and important part of what doctors do, by Yale School of Medicine physician Dr. Lisa Sanders, author of the monthly New York Times Magazine column "Diagnosis," the inspiration for the hit Fox TV series House, M.D. "The experience of being ill can be like waking up in a foreign country. Life, as you formerly knew it, is on hold while you travel through this other world as unknown as it is unexpected. When I see patients in the hospital or in my office who are suddenly, surprisingly ill, what they really want to know is, �What is wrong with me?� They want a road map that will help them manage their new surroundings. The ability to give this unnerving and unfamiliar place a name, to know it�on some level�restores a measure of control, independent of whether or not that diagnosis comes attached to a cure. Because, even today, a diagnosis is frequently all a good doctor has to offer." A healthy young man suddenly loses his memory�making him unable to remember the events of each passing hour. Two patients diagnosed with Lyme disease improve after antibiotic treatment�only to have their symptoms mysteriously return. A young woman lies dying in the ICU�bleeding, jaundiced, incoherent�and none of her doctors know what is killing her. In Every Patient Tells a Story, Dr. Lisa Sanders takes us bedside to witness the process of solving these and other diagnostic dilemmas, providing a firsthand account of the expertise and intuition that lead a doctor to make the right diagnosis. Never in human history have doctors had the knowledge, the tools, and the skills that they have today to diagnose illness and disease. And yet mistakes are made, diagnoses missed, symptoms or tests misunderstood. In this high-tech world of modern medicine, Sanders shows us that knowledge, while essential, is not sufficient to unravel the complexities of illness. She presents an unflinching look inside the detective story that marks nearly every illness�the diagnosis�revealing the combination of uncertainty and intrigue that doctors face when confronting patients who are sick or dying. Through dramatic stories of patients with baffling symptoms, Sanders portrays the absolute necessity and surprising difficulties of getting the patient�s story, the challenges of the physical exam, the pitfalls of doctor-to-doctor communication, the vagaries of tests, and the near calamity of diagnostic errors. In Every Patient Tells a Story, Dr. Sanders chronicles the real-life drama of doctors solving these difficult medical mysteries that not only illustrate the art and science of diagnosis, but often save the patients� lives.… (more)
User reviews
The case studies she presents here are often fascinating in themselves, as medical detective stories, but what makes this book really worth reading is its eye-opening look at the difficulties of diagnosis, the all too many ways in which doctors can fail, and the potential ways in which doctors, patients and teachers can work to improve things.
It is, however, also mildly terrifying, especially for someone with occasional hypochondriac tendencies, to be so vividly reminded of all the strange, hard-to-figure-out things that can go badly wrong in the human body. And it may be very useful and important to be reminded that doctors are fallible human beings like the rest of us, but damn it, I still desperately want them to magically know what's wrong with me when I ask.
This inside look at how a doctor thinks, and how they manipulate the smallest symptoms or other clues to diagnose everything from West Nile to Cannabinoid Hyperemesis (yes, as in cannabis) is illuminating. And the anecdotes are good representatives to make Sanders’ aside point, that medical shortcuts are affecting the ability of doctors to make a correct diagnosis resulting in sub par care. Whether the fault is the skip of the routine physical exam or the brevity allotted for patient history and back story of an ailment, Sanders takes shots at the prevalent standards of practice. These points make for a scary but essential read. Skip this one at your own risk.
Diagnosis focuses on the challenges faced by doctors when attempting to diagnose the cause of a patient's illness. Sanders explores tools such as the traditional physical exam, the knowledge accumulated by individual doctors and the ever-increasing use of diagnostics such as CAT, MRI and echocardigraphs.
Interpersed between all these aspects are a collection of short tales - each recounting a particular medical mystery. Each case study clearly illustrates and highlights the relevant topic under discussion. From West Nile disease to the uncommon CannabinoidHyperemesis, Sanders takes the reader through a wide range of medical puzzles and the challenges facing today's doctors.
In an world with an ever-increasing amount of medical knowledge, a large dependence on technology, and decreasing use of the traditional exam, how will tomorrow's doctors fare? It makes the reader aware of the fact that doctors are human too, not all-knowing oracles of truth. Diagnosis is written in clear English, and is more than suitable for a non-medical person to pcik up and read. A very interesting and honest book.
Then, the book takes a strange turn when it starts to talk about Lyme disease - what begins as a standard description of a patient case unravels into what can only be described as a rant against doctors who champion the idea (seemingly mistakenly) about a condition called "chronic Lyme disease." I understand that Dr. Sanders feels strongly about the issue and I appreciate her passion, but it's rather misplaced in this particular book.
The last section of the book talks about something I find very interesting - the internet's role in future diagnosis! This part discusses the beginnings of medical databases and how the internet has made most of them obsolete - enlightening and really rather funny for anyone who has ever Googled a symptom!
“…what captured my imagination were the stories doctors told about their remarkable diagnoses – mysterious symptoms that were puzzled out and solved”.
In this book, Sanders shares the stories she has come across, whther personally or secondhand. Some of them are rather intriguing, and would definitely fit into an episode of House. She advocates the return of the physical exam, which was once the centre of a diagnosis, but has now been replaced with lab work or diagnostic imaging. She argues that medical students and practicing physicians have lost some skills as a result: learning to listen, learning to feel, learning how to see.
Sanders isn’t the most evocative of writers. While the cases are fascinating, a few days after reading this book, I couldn’t quite remember them anymore. Perhaps I had other things on my mind. Finishing my work for instance, the little one moving around inside of me (one month to go!). I obviously wouldn’t make it as a doctor – in one ear out the other is not a skill one would appreciate in a doctor. At any rate, this was an enjoyable read, which is perhaps odd to say, as this is a book full of sick and dying people. It’s obviously not a comforting read either, as this book makes it all too clear that doctors are human, that they make mistakes, plenty of mistakes, mistakes that could’ve been caught early on.
A good read if you’re interested in how a doctor thinks, and how diagnosis works. Or if you’re just a fan of House!